Hospital Challenges: Inflation and Competition

Hospital Challenges in 2023 as discussed in a Becker's Hospital Review Webinar.

Challenge #1: Inflation
Overall Hospital Cost rose 16% in 2022 for both supplies and labor. Labor inflation is in part driven by needing to pay traveling nurses upwards of $200 per hour. Historically, many hospitals paid their own nurses $30 per hour.

Challenge #2: Margin Skimming
Hospital Systems are being challenged by competing hospital systems that are opening Ambulatory Surgery Centers and Imaging Centers (i.e. outpatient facilities) in their geography and 'skimming' high-margin surgeries and imaging away from their hospital.

Specifically, Hospital Corporation of America (HCA) is increasing it ratio of outpatient facilities to hospitals from 12:1 to 20:1... almost Double!

In response to these challenges, some hospitals are merging with other hospital systems.

For example, the SCL Hospital System in Colorado is merging with Intermountain Health Care.

Challenge #3: Low Patient Volume
Patient volumes at hospitals is still below Pre-COVID levels. Overall hospital admits are 83% of Pre-COVID Levels. ER visits are at 91%. Surgeries are at 89%. Outpatient visits are at 86%.

Features CEOs and a CFO from 3 major hospital systems in America, along with the hospital consulting firm VMG Health.

Sources:

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I’m an orthopedic surgery resident with a background in finance/economics. Your videos are excellent and I’ve learned a lot from you. Thank you.

[monaoconnell]

A patient recently in Greensboro, N.C. went to the hospital for a relatively routine operation. The patient stayed in the hospital one night. After the surgeon and the anesthesiologist were paid, the hospital charged $51, 000. That is insane.

[oumichael]

Outstanding information! Been in this business for a long time. Sometimes we miss the forest for the trees. This is a great presentation. Please keep up the awesome work!

[EricCRO]

I’m not even in the health field, but I love learning about this, idk why, it’s too interesting

[suns]

If you have time can you please look into this topic. I can go more into details if you're curious. So a PMHNP outpatient is seeing the same amount of doctors as a psychiatrist. They have a collaboration agreement and the PMHNP is generating 100% of the physician reimbursement for each patient.
The PMHNP practices independently 99% of the time and consult the physician 1% of the time.
The PMHNP does three, 99214 AND psychotherapy per hour. Each of them bring in around $150. So $450/hr. Yet they are making like $60-70 per hour. I know there are a lot of other expenses but can you please explain how this is remotely possible or ethical?
And I'm not talking down on the position by any means but can you explain how there is such a huge salary difference between them.
I would have no problems if they were seeing different acuity patients but they're seeing the same exact patients.

[lukeroberts]

Awesome content. After watching your video, I would be interested in watching a video you make to learn more about Intermountain Healthcare, they vertical approach is intriguing. Thanks for your consideration.

[azppmd]

Good content, but audio quality sucks, which detracts from the content and speaker authority.

[CarlWoeseWins]

In my experience, hospitals wish to increase admissions. They push more transfers as well. They very obviously want every bed full. Isn't that how they make money other than elective procedures? According to this video, are you saying the hospital and health systems are failing when they admit more or are you saying they don't want admits? Because I would agree our outpatient health systems are lacking when we have to admit more, but hospitals obviously have an incentive to admit. They likely lobby for this as well.

I love your videos regardless, thank you for making them.

[furvaraza]

Can you please do a video on how NPs with collaborative physician’s billing work and how they make money for hospitals. Thank you.

[sanadbenali]

Great video doc, I have a question about hospitals charging ambulance: the story goes that a ambulance responds to a RTA they find a child who is illegal in the country that needs medical attention

After taking the child to the hospital they were given the bill

My question is wouldn't such a child be in care of the government and they would get the bill

[monaoconnell]

I strongly disagree that the doctors are the main expense in a hospital.

[eugenepoz]

Thank you! Was there a question about their salaries and KPI’s that they are measured by? ;)

[DigitalNegative]

You say you hav no involvemnt with BEcker's and yet you're name is suspiciously similar; isn't it, Dr. Bricker? Curious.
But really, thank you for another informative video Dr. Bricker.